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Flashcards in Haem1 Deck (417)
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301

T/F? GVHD involving liver p/w hepatitic LFT derangment False

usually p/w cholestatic LFTs. DDx: veno-occlusive disease

302

Hepcidin is involved in control of iron absorption. Which of the following conditions would be a/w high hepcidin. A) Anaemia. B) Iron deficiency. C) Thalassaemia. D) Sideroblastic anaemia. E) Haemochromatosis. F) Chronic inflammation. Both Anaemia

Chronic inflammation.

303

The JAK2 mutation is in what % of PRV

and what % of ET? PRV - 95%

304

Are the following cytogenetics favourable are unfavourable? inv(16)

t(8

305

Are the following cytogenetics favourable are unfavourable? inv(16); t(8;21); t(15;17)

Favourable

306

In ALL, which of the following are favourable? Which are unfavourable? BCR-ABL, MLL rearrangement

Both are unfavourable; they'll do poorly. Need aggressive post-remission therapies

307

What's imatinib, and how is it used?

It's molecular targeted therapy at tyrosine kinase, added on to chemoTx, and has drastically improved prognosis of CML

308

The cytogenetic marker, 'del 5q' is found in what condition?

Subtype of MDS. This type is responsive to lenalidomide.

309

In which part of the GIT is iron absorbed?

Duodenal enterocytes

310

Where in the body is transferrin synthesised?

In liverr

311

There are two types of transferrin receptors (types 1 & 2). Where are they located, and which is implicated in HH?

Type 1 - major binding port for iron, found on most cells. Binds transferrin 30x stronger than TfR2.

312

What is ferritin?

It's a storage facility for iron. Ferritin consists of an apoprotein shell with light & heavy chain subunits, which surround a core of iron atoms.

313

How do ferritin levels help us work out how much iron is in the body?

Cells excrete the same amount of ferritin storage units into the blood stream as they currently have inside them, and so checking the ferritin levels in the blood gives us an indication of how many ferritin 'storage units' there are within the cells, and from there, we can guess what amount of iron is present in the cell

314

What's the main driver of ferritin production?

Iron in cells.

315

What's the link between hepcidin and ferroportin?

Hepcidin causes internalisation of ferroportin, and so iron has no way of leaving the cell (it's only exit is via ferroportin). When body has low iron in storage, hepcidin expression is reduced (to allow ferroportin to stay on cell membrane & get iron out of cell into blood); and vice versa

316

Which type of HD carries the best prognosis?

Lymphocyte predominant

317

T/F? With regards to Hodgkins Disease, the presence of B symptoms implies a better prognosis

False - worse prognosis

318

Name 2 poor prognostic factors for HD?

As per NEJM 1998

319

Name an alkylating agent

Cyclophosphamide - causes cross-linking of DNA. S/Es: haemorrhagic cystitis, myelosuppression, transitional cell carcinoma

320

Name a S/E of bleomycin

Lung fibrosis

321

Name a S/E of doxorubicin

Cardiomyopathy

322

Name 2 anti-metabolite drugs

MTX

323

Name a chemoTx agent that causes peripheral neuropathy

Vincristine

324

Name 2 modalities which may help improve metastatic bone pain

NSAIDs

325

Name cytogenetic abnormalities for: a) CML, b) APML, c) Burkitt's, d) Mantle cell lymphoma

a) CML - t(9:22) - Philadelphia chromsome; BCR-AbL

326

What's the first-line treatment for pyoderma gangrenosum?

Oral steroids; if not resolving, try immunosuppressive therapy (ciclosporin, infliximab)

327

Name 2 causes of warm AIHA

AID, eg SLE

328

Name 2 causes of cold AIHA

Neoplasia, eg lymphoma

329

How do you treat warm AIHA?

Steroids

330

How do you diagnosis hereditary haemorrhagic telangiectasia?

Aka Osler-Weber-Rendu syndrome, is an AD condition characterised by multiple telangiectasia over skin / MMs. If you meet 2/4 of following = 'possible' diagnosis, if you meet 3/4 or 4/4 = 'definite' diagnosis. 1) Recurrent, spont. epistaxis. 2) Telangiectases (lips, mouth, fingers, nose). 3) AVMs in GIT, hepatic, cerebral, spinal, lungs. 4) FHx (1st degree relative) with HHT